Li Lifeng, Gao Yanyong, London Nyall R, Kou Xiujuan, Wang Weiwei, Xu Hongbo, Chen Xiaohong
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1st Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2581-2587. doi: 10.1007/s00405-024-09142-6. Epub 2024 Dec 12.
A transoral surgical corridor can provide adequate exposure for extirpation of benign tumors arising from the parapharyngeal space (PPS). However, peri-operative complications following a transoral approach to the PPS have not been sufficiently described. This study retrospectively reviewed patients with PPS tumor extirpated via an endoscopic-assisted transoral approach, aiming to evaluate the safety of this approach and summarize the peri-operative complications.
One hundred consecutive patients who underwent an endoscopic-assisted transoral resection of PPS benign tumors at a university hospital were enrolled. Indices including intraoperative catastrophic bleeding, cerebral spinal fluid (CSF) leak, post-operative respiratory airway swelling, cranial neural injury, operative field infection, oral suture dehiscence and venous thrombosis, were assessed from the date of surgery to 3 months after the surgery.
Tumors in the PPS were safely and successfully removed via an endoscopic-assisted transoral approach for all 100 patients. Intra-operative CSF leak occurred in 3 patients, while the CSF leak was appropriately repaired intraoperatively without long-term post-operative CSF leak. No catastrophic bleeding, respiratory airway swelling, and operative field infection occurred. Cranial neuropathy occurred in 16 patients, five of whom fully recovered, while the remainder demonstrated permanent neural deficits. Oral suture dehiscence occurred in 13 patients, and all patients healed well after wound packing. Deep vein thrombosis was observed in three patients and pulmonary embolism in one patient, however, no severe consequences happened.
An endoscopic-assisted transoral corridor is safe and effective for benign tumor extirpation in the PPS with few peri-operative complications.
经口手术通道可为切除起源于咽旁间隙（PPS）的良性肿瘤提供充分的暴露。然而，经口入路处理PPS后的围手术期并发症尚未得到充分描述。本研究回顾性分析了经内镜辅助经口入路切除PPS肿瘤的患者，旨在评估该入路的安全性并总结围手术期并发症。
纳入在一所大学医院接受内镜辅助经口切除PPS良性肿瘤的连续100例患者。评估从手术日期至术后3个月的指标，包括术中灾难性出血、脑脊液（CSF）漏、术后呼吸道肿胀、颅神经损伤、术野感染、口腔缝线裂开和静脉血栓形成。
所有100例患者均通过内镜辅助经口入路安全、成功地切除了PPS肿瘤。3例患者术中发生CSF漏，术中均进行了适当修复，术后无长期CSF漏。未发生灾难性出血、呼吸道肿胀和术野感染。16例患者发生颅神经病变，其中5例完全恢复，其余患者表现为永久性神经功能缺损。13例患者发生口腔缝线裂开，所有患者经伤口填塞后愈合良好。3例患者观察到深静脉血栓形成，1例患者发生肺栓塞，但均未造成严重后果。
内镜辅助经口通道对于PPS良性肿瘤切除是安全有效的，围手术期并发症较少。
